Cognitive strengths in first-episode psychosis: perspectives from young people with lived experience

Background: Identifying cognitive strengths may be one avenue for enhancing functional recovery in people with first-episode psychosis (FEP). This study explored the perspectives of young people with FEP on the conceptualisation of cognitive strengths and the perceived risks and benefits, and pragmatic considerations, of a cognitive strengths-based approach to assessment and treatment. Methods: Ten participants, aged 18 to 26 (Mage = 21.44 years, SD = 2.70), were recruited from an early psychosis assessment and treatment service. Data were collected using a semi-structured interview and analyzed using thematic analysis. Results: Four overarching themes emerged, related to: 1) Understanding cognitive strengths in FEP; 2) Potential benefits; 3) Barriers and risks; and 4) Considerations for development and implementation. Young people held positive views toward assessment and treatment methods focused on cognitive strengths, suggesting that identifying strengths and building confidence beliefs may promote greater functioning. Potential barriers, including harms related to being unable to identify cognitive strengths or neglecting deficits, were areas requiring further consideration. Discussion: A cognitive strengths-based approach to assessment and treatment in FEP is a promising area of investigation, according to young people with FEP. The results provide insight regarding a cognitive strengths definition and the ways that these could be measured in future.